Value of ultrasound detection of fetal umbilical artery and middle cerebral artery blood flow in diagnosis of fetal intrauterine distress

doi:10.3877/cma.j.issn.1672-6448.2023.06.008

Abstract

Abstract:

Objective

To evaluate the value of ultrasound detection of fetal umbilical artery (UA) and middle cerebral artery (MCA) blood flow in the diagnosis of fetal intrauterine distress.

Methods

A retrospective analysis was conducted on the medical records of 200 pregnant women admitted to Xinjiang Production and Construction Corps Hospital from March 2020 to October 2021. They were divided into a normal group of 124 cases and a distress group of 76 cases based on whether fetal distress occurred during pregnancy. UA and MCA blood flow indicators (resistance index [RI] and ratio of maximum systolic flow velocity to end diastolic flow velocity [S/D ratio]) at 28-32 weeks and 33-36 weeks of pregnancy were recorded and compared between the two groups. The sensitivity, specificity, and area under the ROC curve (AUC) of UA and MCA blood flow indicators (RI and S/D ratio), alone or in combination, in diagnosing fetal distress were calculated.

Results

The RI and S/D ratio of UA blood flow at 28-32 weeks and 33-36 weeks in the distress group were significantly higher than those in the normal group (P＜0.05), while the RI and S/D ratio of MCA blood flow in the distress group at 28-32 weeks and 33-36 weeks were significantly lower than those in the normal group (P＜0.05). The sensitivity, specificity, and AUC of the combination of UA and MCA blood flow indicators in the diagnosis of fetal distress at 28-32 weeks of pregnancy were 96.05%, 90.32%, and 0.978, respectively, which were higher than those of either UA or MCA blood flow indicators alone (P＜0.05). The sensitivity, specificity, and AUC of the combination of UA and MCA blood flow indicators in the diagnosis of fetal distress at 33-36 weeks of pregnancy were 78.95%, 87.90%, and 0.906 respectively, which were higher than those of either UA or MCA blood flow indicators alone (P＜0.05).

Conclusion

The combination of UA and MCA blood flow indicators has high diagnostic value for fetal intrauterine distress, and is of great significance for the clinical diagnosis and interventional treatment of fetal intrauterine distress.

Key words: Ultrasonography, prenatal, Fetus, Umbilical artery, Middle cerebral artery, Fetal distress

Ze Yuan, Li Zhuang. Value of ultrasound detection of fetal umbilical artery and middle cerebral artery blood flow in diagnosis of fetal intrauterine distress[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 618-621.

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References 9

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组别	例数	RI		S/D
组别	例数	28~32⁺⁶周	33~36⁺⁶周	28~32⁺⁶周	33~36⁺⁶周
窘迫组	76	0.67±0.13	0.62±0.12	3.45±0.55	3.43±0.82
正常组	124	0.54±0.11	0.51±0.12	2.78±0.48	2.68±0.86
t值		7.564	6.292	9.060	6.092
P值		＜0.001	＜0.001	＜0.001	＜0.001

组别	例数	RI		S/D
组别	例数	28~32⁺⁶周	33~36⁺⁶周	28~32⁺⁶周	33~36⁺⁶周
窘迫组	76	0.67±0.13	0.62±0.12	3.45±0.55	3.43±0.82
正常组	124	0.54±0.11	0.51±0.12	2.78±0.48	2.68±0.86
t值		7.564	6.292	9.060	6.092
P值		＜0.001	＜0.001	＜0.001	＜0.001

组别	例数	RI		S/D
组别	例数	28~32⁺⁶周	33~36⁺⁶周	28~32⁺⁶周	33~36⁺⁶周
窘迫组	76	0.42±0.08	0.39±0.12	3.33±1.05	3.17±0.82
正常组	124	0.56±0.13	0.52±0.17	4.52±1.12	4.14±1.07
t值		8.454	5.833	7.467	6.775
P值		＜0.001	＜0.001	＜0.001	＜0.001

组别	例数	RI		S/D
组别	例数	28~32⁺⁶周	33~36⁺⁶周	28~32⁺⁶周	33~36⁺⁶周
窘迫组	76	0.42±0.08	0.39±0.12	3.33±1.05	3.17±0.82
正常组	124	0.56±0.13	0.52±0.17	4.52±1.12	4.14±1.07
t值		8.454	5.833	7.467	6.775
P值		＜0.001	＜0.001	＜0.001	＜0.001

组别	敏感度（%）	特异度（%）	约登指数	AUC	95%CI	截断值	P值
UA血流RI	61.84	76.61	0.385	0.776^a	0.712~0.832	0.61	＜0.001
UA血流S/D	61.84	87.90	0.498	0.815^a	0.754~0.866	3.31	＜0.001
MCA血流RI	88.16	65.32	0.535	0.814^a	0.753~0.865	0.51	＜0.001
MCA血流S/D	63.16	81.45	0.446	0.787^a	0.723~0.841	3.57	＜0.001
UA与MCA联合	96.05	90.32	0.864	0.978	0.946~0.993	-	＜0.001

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